title: Irritable bowel syndrome-type symptoms in female patients with mild systemic lupus erythematosus: frequency, related factors and quality of life.
abstract: BACKGROUND
  Irritable bowel syndrome (IBS) impairs quality of life (HRQOL), as does systemic lupus erythematosus (SLE). Both are more common in women and are associated with fibromyalgia (FM). However, the relationship between IBS and SLE and its impact on HRQOL has not been explored. Therefore, we aimed to study the frequency and features likely to influence the presence of IBS-type symptoms in SLE and their impact on HRQOL.
  
  
  METHODS
  Female patients with SLE were studied. The presence of IBS-type symptoms and bowel habit subtype were established by Rome III criteria and HRQOL was assessed using the SF-36. Fibromyalgia and depression were assessed using the American College of Rheumatology criteria and CES-D scale, respectively.
  
  
  RESULTS
  A total of 105 consecutive patients (43.62 ± 11.34 years old) were included; 48.6% had IBS-type symptoms (SLE+IBS) and were classified as IBS-C: 23.5%, IBS-D: 37.3%, and IBS-M: 39.2%. In addition, 23.8% had FM. SLE+IBS vs Non-IBS SLE patients had higher SLE activity scores (2.55 ± 1.65 vs 1.74 ± 2.19; p = 0.03), were more likely to have FM (33.0% vs 14.8%; p = 0.02) and depression (41.1% vs 25.9%, p = 0.04). Logistic multivariate analysis showed that IBS-type symptoms were associated with FM (OR = 2.85, 95% CI: 1.11-7.43) and depression (OR = 1.07, 95% CI: 1.02-1.13). Finally, SLE+IBS vs Non-IBS SLE patients had lower SF-36 scores (49.65 ± 18.57 vs 62.67 ± 18.14; p = 0.02).
  
  
  CONCLUSIONS
  IBS-type symptoms are highly prevalent among women with SLE and are associated with FM and depression. SLE+IBS patients had worse HRQOL vs Non-IBS SLE, independently of FM status. We suggest that treating IBS symptoms may improve HRQOL in women with SLE.
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Hospital General Regional No. 36, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Puebla, México; Immunology and Rheumatology, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Puebla, México.
authors.forename: M
authors.initials: M
authors.lastname: García Carrasco
authors.forename: C
authors.initials: C
authors.lastname: Mendoza Pinto
authors.forename: A
authors.initials: A
authors.lastname: López Colombo
authors.forename: S
authors.initials: S
authors.lastname: Méndez Martínez
authors.forename: R
authors.initials: R
authors.lastname: Andari Sawaya
authors.forename: M
authors.initials: M
authors.lastname: Muñoz Guarneros
authors.forename: L
authors.initials: L
authors.lastname: Vázquez De Lara
authors.forename: M
authors.initials: M
authors.lastname: Lescas Hernández
authors.forename: A
authors.initials: A
authors.lastname: Montiel Jarquín
authors.forename: G
authors.initials: G
authors.lastname: Ramos Álvarez
authors.forename: M
authors.initials: M
authors.lastname: Schmulson
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*
keywords: IBS; fibromyalgia; functional gastrointestinal disorders; health-related quality of life (HRQOL); irritable bowel syndrome-type symptoms; systemic lupus erythematosus